Becker's asked C-suite executives from hospitals and health systems across the U.S. to share their organization's areas of growth for the next few years.
The 65 executives featured in this article are all speaking at the Becker's Healthcare 14th Annual Meeting on April 8-11, 2024, at the Hyatt Regency in Chicago.
To learn more about this event, click here.
If you would like to join as a reviewer, contact agendateam@beckershealthcare.com. We'll fully cover your registration fee!
For more information on sponsorship opportunities, contact Jessica Cole at jcole@beckershealthcare.com.
As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: What will be different about health systems 3 years from now?
Peter D. Banko. Region President of CommonSpirit Health (Chicago): In three years, the patient will – finally after all this talk – be the ultimate consumer. We will deliver uber-friendly technology to consumers like companies have delivered for every other part of our lives. Consumers will access at their fingertips information – care processes, best practices, research, risks, benefits, costs, and outcomes – to further their own understanding and ability to impact their care.
More technology and more information will drive different and collaborative care models that are consistent and regularized creating far better processes, hand-offs, and outcomes as well as greater opportunities for self-diagnosis and self-care. For health systems and providers, competition will, as a result, be based less on quality, safety, affordability and value (those are now "table stakes,") and more on the ability to innovate consumer experience and system connectedness.
Cliff A. Megerian, MD, FACS, CEO of University Hospitals (Cleveland): I think we will continue to see margin pressure resulting from reimbursement rates not keeping pace with inflationary trends that are escalating staffing and supply chain costs. As a result, you will see health systems optimizing their operations which may include footprint re-evaluation, increasing focus on value-based care, and greater utilization of digital technology, such as remote monitoring and telehealth services. There will likely be more collaborations and partnerships to expand services and increase access versus brick-and-mortar acquisitions. Innovative thinking is critical for success, and quite frankly survival in our industry, so health systems should already be investing in growing in-house expertise dedicated to ideating new models of care, but in three years, these efforts should be producing tangible returns.
John Couris. President and CEO of Tampa (Fla.) General Hospital: If health systems are going to continue to thrive and survive in the years to come, they will need to dramatically invest time, resources, and people into developing robust ecosystems of care. By this I mean, they will need to build pathways where patients can access the specific type of care they need in an environment that most effectively, efficiently, and affordably serves both the patient and the provider. We will need to deploy new technology and leverage innovative approaches to making this happen. At the same time, we must effectively coordinate all of the care patients receive so that they move through the system without friction, can get the care they need promptly, and where potential health concerns are addressed early, leading to improved outcomes.
Amy Perry. President of Banner Health (Phoenix): The most successful health systems will be able to offer complete care and coverage. On the care side, that means having invested in fully integrated care, serving patients beyond acute care settings, and filling in gaps in care to make healthcare easier, more accessible and more affordable. Coverage, or premium-based revenue, allows health systems to prioritize health outcomes and quality of life. All of this must be fueled and integrated by the smart application of emerging technology. Health systems must accelerate their ability to transform.
Michelle Fortune. CEO of Atrium St. Luke's Hospital (Columbus, N.C.): I expect to see an increase in collaborations and connections between health systems to a degree that has never existed before - as part of the focus on bringing the right care to people, across the full continuum, when and where they need it. This includes the transition of certain inpatient services to safe, convenient and effective outpatient models, further growth of population health management and the reduction of rural health inequities that threaten our healthcare safety net.
Recent collaborations between Mercy, Microsoft and Mayo Clinic are excellent examples of how healthcare systems can use improved data sharing, generative AI and digital technologies to navigate challenges and innovate improved efficiencies in care. These efforts allow physicians, providers and care teams to be fully present with patients and their families while delivering high quality, high value care to everyone.
Gina Calder. President of Barnes Jewish St. Peters Hospital and Progress West Hospital (St. Peters, Mo.): The short answer is everything, but there are a few areas we are really focused on:
Staffing: Not only is there an increasing shortage in available talent needed to care for a growing patient base, the expectations of our people are also changing. As we diversify our talent base, we also need to diversify our culture and create new growth opportunities for more dynamic career experiences.
Patient Care: The patient population is growing, and there are concerning health trends in America relative to obesity, maternal health (especially in underserved communities as we're addressing elsewhere in the BJC HealthCare system through our Community Health Improvement doula program), mental health and the devastating impact of fentanyl.
Technology and data: We are still at the very beginning of the integration of AI. Healthcare will always be about people treating people, but as AI matures it has the potential to be a game changer in diagnosing and treating disease – but, if not prudently managed, to also increase inequities. Deeper application of technology in healthcare will uncover new opportunities to expand the scale and scope of delivery platforms. The ability to process all the data at our disposal to more quickly identify trends and opportunities to enhance care also has the potential to dramatically improve patient outcomes.
Finally, it's the unknown. Four years ago, very few people would have listed a global pandemic in answering this question. We have to acknowledge – and be prepared for – major changes in healthcare and health systems that we can't yet predict.
David Verinder. President and CEO of Sarasota (Fla.) Memorial Health Care System: The hospitals of tomorrow are being planned today, so it's incumbent on hospital leaders to not only consider the healthcare needs of the communities and patients they currently serve, but also to continually look forward to ensuring we are transforming care well into the future. Sarasota Memorial Health Care System has invested more than $1 billion over the past three years in new, state-of-the-art facilities (including a new hospital, multiple cancer centers and new behavioral health hospital) that offer the latest advances in healthcare and meet the evolving needs of our growing community.
In the coming years, we are planning additional investments in projects and programs that are expandable and flexible, knowing we cannot always predict how new technologies will impact care. Because it's not just about bricks and mortar. In the coming years, health systems must integrate not only the latest medical equipment and robust clinical programs for patients.
They also must harness the power of AI and innovative digital health advances to help predict, diagnose and treat diseases, add greater personalization and precision to medicine, expand patients' access to comprehensive care, and improve efficiencies within the workforce.
Mark Behl. President and CEO of NorthBay Health (Fairfield, Calif.): The short answer is "everything." We are in one of the most interesting times for health systems. Health systems are standing on the next frontier of American healthcare. A future of uncertainty, hope, and threats await as we have emerged from the past few years of duress and steadied our financial positions. We are at an inflection point. What has worked in the past, will simply no longer work in the future. Over the next few years we will need imagination, bold ideas, and the courage to think differently.
Although we are talking about the next three years, in my opinion, we should be asking our systems: what should we look like in 20-30 years? Because only then, do we start building the right foundation to be successful in this next frontier. If we look that far in the future, how many of our legacy workflows will be automated (and if so, shouldn't we be pursuing automation with much greater intensity). And what about payment models? If we all agree that traditional fee-for-service is unsustainable (and not providing the results we want or need), and the move toward more of a prepaid model is where we will be at some point in the not-to-distant (or distant) future, then what are the building blocks necessary to begin working on today?
On the one hand, three years is a relatively short period of time. However, in healthcare, a lot can change quickly. So on the other hand it's a very long time. I suspect we will see more mergers and acquisitions, with a continued desire to grow larger to remain relevant. Independent regional health systems will fight for relevance (and sometimes survival), rural hospitals will continue closing, and the large insurance companies will make money (some things never change).
Patrick Frias, MD. President and CEO of Rady Children's Hospital-San Diego: I think you will see a greater focus on precision medicine and technological innovation. Over the next few years, health systems may turn more to genomic medicine to diagnose disease and develop treatment plans. At Rady Children's, we've launched an initiative to supplement traditional newborn screening with rapid whole-genome sequencing in order to identify genetic diseases in newborns before they become ill. Pediatric health systems will need to continue to support mental and behavioral health strategies to address the mental health crisis in kids. I would also expect, and hope, to see major investments in health equity, ensuring that the care provided is delivered equitably to all.
Michael A. Young. President and CEO of Temple University Health System (Philadelphia): We're going to see a lot more automation: mobile-friendly patient scheduling and check-in, more rapid triage and diagnosis of illness, real-time monitoring of treatment adherence — all of this will improve access, quality, and efficiency leading to better health and business outcomes. Enhancements of care will drive even more care delivery to the outpatient setting leading to higher acuity inpatient care. There will be fewer of us remaining systems — as ongoing reimbursement pressures, increasing labor and supply costs, and claim denial challenges make it impossible for smaller hospitals to operate, forcing more closures.
Steve Davis, MD. President and CEO of Cincinnati Children's (Ohio): Health systems will continue to evolve in the coming years, even more rapidly than in prior years. Some of this evolution will depend on the results of the upcoming elections. A few areas of potential meaningful change include increased use of telemedicine, particularly to address the access to care issues in many rural areas, a greater focus on preventive and population health initiatives, and greater incorporation of AI tools into the diagnostic toolset and allowing for better integration of big data approaches with the efforts around more personalized medicine. Access, affordability, and the healthcare worker shortage issues will be even more challenging in the upcoming years. The shortage of pediatric subspecialists continues to worsen, without significant changes in reimbursement models, loan forgiveness programs, and other innovative approaches, many children will be without access.
Bill Morice, MD, PhD. President and CEO of Mayo Clinic Laboratories (Rochester, Minn.): We anticipate several changes in health systems as they embrace and utilize digital technologies to address increasing access and improving the patient experience. The central role that diagnostics play in care delivery will lead to increased use of digitized remote diagnostics and expand the availability of at-home testing. In tandem, telehealth will continue to evolve to provide healthcare to patients in underserved areas of the country.
Marrying telehealth with at-home diagnostics will drive health systems to expand their care beyond their physical infrastructure, which will not only increase patient convenience but also drive lower costs through increased efficiency of care and better outcomes. Ultimately, this will lead to a rethinking of the way health systems operate and how they are supported by their physical infrastructure, but that rethinking is on a longer horizon than three years.
Joseph Webb. CEO of Nashville General Hospital: I believe the following three areas will be critical for healthcare delivery over the next three years.
Staffing shortages will continue to drive workforce challenges in healthcare systems/organizations. Staffing shortages are not new by any means; however, they have been exacerbated by growing demand for healthcare availability largely driven by an aging population and an increasing need for healthcare at all levels.
In the presence of extreme workforce challenges/shortages, AI will continue to gain momentum in providing more aspects of healthcare delivery as an alternative to physical bodies.
Because of a growing prevalence of health inequities, there will likely be an increase in the uptake of innovative activities to address increased resource consumption. Health inequities are largely driven by social determinants of health which are fundamental causes of health disparities. United States healthcare social entitlement programs, e.g., Medicare and Medicaid are experiencing a continuous escalation of costs driven by systemic health inequities.
Expect to experience growth in value-based initiatives designed to improve health outcomes (population health management) and reduce costs among statistically indicated at-risk populations.
Elizabeth Wako, MD. President, CEO of Swedish Health Services (Seattle): In the next three years, I believe healthcare will see a continued embrace of digital technologies, an increased focus on preventive care, and a growing emphasis on personalized medicine. Telehealth and remote patient monitoring are likely to become more integrated into mainstream healthcare delivery, providing convenient and accessible options for patients.
Virtual nursing programs will be an innovative way to address workforce and nurse staffing needs, allowing a virtual nurse to care for patients and support the bedside team through a bi-directional audio/video platform. In addition, artificial intelligence and data analytics will play a pivotal role in enhancing diagnostics, treatment plans and operational efficiency.
Nancy Howell Agee. CEO of Carilion Clinic (Roanoke, Va.): Successful health systems will be hyper-focused on easy access and patient experience at every step of the journey. We will obsessively engage with patients and deliver care that goes beyond medical expertise and includes comfortable environments. We'll eliminate wait times and use technology that streamlines processes. As health care leaders, innovation is in the DNA of every one of us. A future in which care is convenient, easy to access, technologically enhanced and addresses patients' emotional and practical needs.
Lara Klick. Vice President and Patient Experience Officer of Tampa General Hospital (Fla.): The biggest change will be increased access to care and coordination of patient care. Now that patients have become used to accessing care virtually, we will need to maintain that entry point, continuing to increase its ease and speed. This is particularly critical as the demographic of those raised in a connected age grows. Patients will expect immediate, frictionless interactions with their care teams and our health systems must tackle creating a highly reliable, culturally identical experience throughout the continuum of care. As providers and system administrators, we will need to begin to move from measuring episodes of care to measuring the care journey throughout our systems while ensuring that there is no variance in the quality and patient experience anywhere across the system.
Ronald Place, MD. President and CEO of Avera McKennan Hospital & University Health Center (Sioux Falls, S.D.): I see significant innovation in the home care space in the future. In American medicine a hundred years ago, we routinely treated people at home. We progressed into large consolidated acute care facilities as technology advanced, but this care can come at a high cost. We're currently seeing new energy around home care, whether it's home nursing or hospital at home. The organizations who will be successful will figure out how to offer high quality care right in people's homes.
David Goldberg. President and CEO, Executive Vice President of Mon Health System, Vandalia Health (Charleston, W.Va.): Healthcare is ever changing and evolving. As our patients continue to be looking for even more prompt service, technology advances, medicines and care pathways briskly evolve, so will our need in the healthcare environment. We need to stay patient centered, focused on advances made available, disruptors in the healthcare space and ways to do more care efficiently.
Ronda Lehman. President of Mercy Health - Lima (Ohio): Health systems that are able to financially recover from the past few years, will be compelled to reduce services and re-evaluate the scope and breadth of their current services. I hope that we will see additional alignments where health systems are leveraging not just their own strengths, but also looking to other less likely partners to collaborate with. We need to continue to meet consumers where they are at, and relentlessly continue to strive to incorporate "health" into people's everyday lives, rather than allowing barriers to obtaining care. I also believe we will see greater risk-based contracting for all health systems, recognizing that this is vital for us to improve the total health of our communities.
Mary Martin. Interim President and Chief Operating Officer of Duke University Hospital (Durham, N.C.): Three years from now, health systems will feature advances in technology we only dreamed of years ago. From smart hospital rooms that can dictate a patient's record in real time, remote nurses handling admission and discharge interviews and AI combining thousands of points of data for billing documentation, the health system of the future will be much more technologically savvy.
Seth Ciabotti. CEO of MSU Health Care at Michigan State University (East Lansing): There will be more consolidation to mitigate risk. I believe we are heading down a path of having only a dozen or so non-academic medical centers/health systems being left in the near future in the US.
Stephen Merz. Chief Operating Officer of Sheppard Pratt Solutions: Bigger. More focused. Less redundancies.
Ebrahim Barkoudah, MD. System Chief and Regional Chief Medical Officer of Baystate Health (Springfield, Mass.): As we look forward to the next three years, health systems worldwide are poised for significant transformations, largely driven by the surge in chronic diseases, technological advancements, policy modifications, and shifts in health financing. The increasing prevalence of chronic conditions necessitates innovative care models, robust preventative measures, and sophisticated health information systems.
Technological innovations promise to enhance access, efficiency, and personalization of healthcare but also pose challenges related to data security and equity. Changes in health financing models will further impact healthcare demand and require strategic adaptations. Moreover, the rising recognition of mental health's role in overall wellbeing signals an urgent need to expand mental health services within health systems. While these impending changes hold potential for improvement, action-oriented strategies ensure a seamless transition toward an improved healthcare system will be needed.
Bethany Daily. Executive Director, Perioperative Services and Healthcare Systems Engineering of Massachusetts General Hospital (Boston): Health systems will continue to get more organized and centralized in their work. In theory, centralization should allow for better decisions on resource utilization across the system (assuming some level of geographic proximity), as pooled resources are available to serve the communities in the health system's service areas. The important detail is the balance between local representation at the hospital/site-level, which affords a true sense of workflows, culture, and capability, and the cost efficiency and investment power of centralized resources.
Beth Steele, MSN, RN. Chief Operating Officer of Owensboro Health Regional Hospital (Ky.): Three years from now, we believe the shift in how we care for people, what we use, and where we do it will continue evolving.
- This means that more care will switch to the outpatient/ambulatory environment or home.
- We also believe technology will continue being a big piece of how we care for our patients differently in the future. This is not just in telemedicine but also in improving the life of our caregivers or in optimizing the workforce.
- We also believe that care models will continue to shift to virtual or mobile versions of care both in and out of the acute care setting. Building and optimizing innovative care delivery and care management will continue to be instrumental in managing lives in a more cost effective manner.
- Community partners, qualified collaborators, and non-traditional pairings will likely be needed to tackle the rising concerns for managing mental health, substance abuse, and workplace violence amongst the operational challenges like workforce and rising expenses.
Joyal Pavey. Vice President, Advisory Group and John F. Butzer Center for Research & Innovation of Mary Free Bed Rehabilitation Hospital (Grand Rapids, Mich.): Health systems are rapidly changing and three years from now many will be unrecognizable. It is likely that we will see a continued rise in care provided in the home, continued growth of ambulatory care services, telemedicine, and rapid hospital consolidations. This consolidation could result in only a few large health systems controlling the health of entire states.
Another change that is likely to occur is a heightened focus on health equity and eliminating health disparities. I believe we will see an increased focus on solving these issues to better the care delivery models for the communities we serve. There will also be a push to solve the healthcare workforce shortage, including high schools being moved within hospitals to encourage curriculum to prepare kids for a career in healthcare, and classrooms for undergraduate and post-graduate work being co-located within health organizations who offer advance, integrated training that blends the classroom with ongoing firsthand experiences.
Lastly, we may see continued commercial and Medicare Advantage insurance plan reform as these plans continue to grow in popularity. Hopefully, with the rapid expansions of these plans, we see increased scrutiny on access to services and the elimination of prior authorization hurdles.
Mara Nitu, MD, MBA. Chief Medical Officer of Indiana University School of Medicine and Riley Hospital for Children, IU Health (Indianapolis): Over the last decade, we grappled with the notion of strengthening the value care model and eliminating harm. While not without risks, I believe employing AI will lead to transformative changes in the medical process, both in the way we practice clinically (image interpretation, differential diagnosis, etc), as well in facilitating the waste elimination efforts.
The second major change will occur in response to consumerism. To meet the expectations of our patients, access to healthcare will evolve to faster, more convenient and diversified platforms.
Matthew Painter. Director, Leadership Development of UAB Health System and School of Medicine (Birmingham, Ala.): In the next three years, we'll begin to see a re-imagined C-suite with a wider skill base including additional culture transformation and organization development roles. This will catalyze a more collaborative leadership as functional executives will partner with others to reduce silos and find operational synergies. There will be a heightened internal emphasis on talent development and team-based care. Investments in culture formation and transformation will rise as strategic imperatives to address current and future workforce opportunities. Care will begin to transform to a more decentralized, community-based care, coupled with increased home-based care and telemedicine.
Anthony Aquilina, DO. Executive Vice President and Chief Physician Executive of WellSpan Health (York, Pa.): I believe health systems will be using technology, particularly AI, to provide a better experience to their customers and to their team members. Health systems will connect with and communicate with patients digitally in a broad menu of services that improve preventive care and health maintenance, ensure appropriate pre-encounter and post-encounter care, and screen for concerns. Systems will use technology to move caregivers away from nonproductive documentation time and allow a more efficient, effective, and satisfied workforce.
Lorraine H. Hutzler. Associate Program Director, The Center for Quality and Patient Safety; Adjunct Assistant Professor, Health Policy and Management of NYU Langone Health (New York City): Increased utilization of wearables technology will improve remote patient monitoring and expand on the data driven approach to personalized patient care. Additionally, through the utilization of artificial intelligence and machine learning, predictive analytics will enhance accuracy and assist in immediate diagnosis through the above-mentioned wearable technologies.
Adele Webb, PhD, RN. Executive Dean, Healthcare Initiatives of Capella University (Minneapolis): I believe that AI will have an enormous impact on how health systems operate in the future. Opportunities to improve care at the bedside and at home will all be enhanced by new and emerging AI technologies. Providers' roles will change and adapt- possibly alleviating some of the issues around lack of staff.
Scottie B. Day, MD. Chair, UK Department of Pediatrics, Physician in Chief at Kentucky Children's Hospital (Lexington): In three years, we will see transformations in health systems from our rapid technological growth to allow more access to more people through telemedicine platforms. I also predict that we will see continued growth in our outpatient practices. We also will need to continue to invest in our people as well as think about how AI technology can help us take care of patients better as well as help with workforce shortages in our practices.
Prashanth Sreeramoju. Director of General Surgery of Montefiore Medical Center (New York City): Health systems will be geared toward patient-centric management approaches in three years for better outcomes. Health systems want to communicate with their patients and find their needs to help them better manage their medical conditions. It is essential for the health system to keep them in their community and also improve patient outcomes.
Darrell Bodnar. Chief Information Officer of North Country Healthcare (Whitefield, N.H.): In the next three years I envision a landscape where AI and machine learning have matured into well-defined, transformative tools reshaping healthcare operations. This evolution will probably impact most sectors and service models. Currently, the potential of these technologies is evident, yet they are still in their infancy. I expect there will be a significant surge in process automation solutions as well, perhaps fueled by the AI maturation.
My hope is these advancements will positively impact the current workforce and labor challenges by enhancing efficiency, effectiveness, and by allowing healthcare professionals to focus on what they do best. Furthermore, the healthcare industry will continue to embrace and expand telehealth, virtual care, and remote patient monitoring, effectively bringing healthcare services directly to patients, wherever they are. This shift towards more accessible care models is not just a trend but a fundamental change in how we approach and deliver healthcare.
Hillery Shay, MBA. Vice President of Marketing and Communications at Children's Minnesota (Minneapolis): The healthcare landscape is one that's constantly changing and evolving daily – let alone annually. Forecasting what will be different three years from now brings a unique perspective to reflect on. I believe one of the biggest differences for health systems 36 months from now will be the expanded presence and impact of non-traditional healthcare players entering our arena. While the concept of more organizations competing for pieces of the same pie can create its own concerns, that competition can also fuel needed improvement in care delivery models, customer experience and value. I'm looking forward to seeing how Children's Minnesota will serve as a trailblazer in this evolution over the next three years to enhance how we serve our patient families.
Patrice M. Weiss, MD. Professor, Clinical Obstetrics and Gynecology of Vanderbilt University Medical Center (Nashville): In three years, health systems will be more things to more people. The industry is trending toward an "omnichannel care" environment where health systems are catering to patient-consumers wherever their needs may be — at home, at the neighborhood pharmacy, in specialty clinics, and of course in hospital settings, too. Through M&A, creative partnerships, expansion, and new technologies, health systems will provide many more options and "menu items" for patients than in the past, all in an effort to keep them engaged and loyal. For leadership this brings about the challenge of integrating disparate facilities, ensuring quality and safety standards across the enterprise, and making sure employees feel unified and rewarded for working for an increasingly complex and diversified system.
Steve Docimo, MD. Executive Vice President of Business Development and Strategy at Children's Hospital of Philadelphia: I will focus specifically on pediatric health systems and children's hospitals. There will be continued consolidation and regionalization in the pediatric marketplace, increasing capacity pressure on children's health resources, particularly during times of viral surge.
At the same time, there will be an explosion in precision medicine approaches, pushing our 'omics and big data capabilities and requiring new facility and workflow approaches to therapy. Despite a more restrained capital environment, higher operating expenses, competition for workforce and increasing need for community-based health investment, children's hospitals will continue to deliver safe, effective and life-changing care.
Sam J. Foss. Vice President of Nursing and Chief Nursing Officer at Mount Desert Island Hospital (Bar Harbor, Maine): As healthcare entities continue to struggle with staffing specifically at the bedside, I foresee healthcare systems rapidly adopting, implementing, and relying heavily on:
- AI to reduce administrative burden allowing RNs to work to the top of their licensure.
- Virtual care platforms that support our direct healthcare team.
- Retention of nursing through innovative wellness programs, meaningful work, and a culture of safety.
Susmita Pati. Chief, Primary Care Pediatrics; Chief Medical Program Advisor, The Alan Alda Center for Communicating Science at Stony Brook University (N.Y.): Three years from now, health systems will be using digital technologies routinely to promote high-quality, safe and efficient care. For example, telehealth will be a first point of entry for the vast majority of mental health care and some acute illnesses. In addition, health systems will be using digital supports (e.g., voice recognition technology) to streamline clinician documentation and maximize the clinician-patient face-to-face time. Virtual/remote clinical monitoring will also be routinely integrated into inpatient care delivery.
Greg Poulsen. Senior Vice President and Chief Policy Officer of Intermountain Health (Salt Lake City): The next three years will be financially stressful for most organizations; as a response, they will seek additional ways to enhance value and lower total cost of care. They will find that accepting additional accountability for total health and total cost of care will provide greater opportunity to be successful at both enhancing health and improving financial performance.
Bharat Magu, MD. Chief Medical Officer of Yuma Regional Medical Center (Ariz.): In the next three years, health systems are poised for a major transformation, largely driven by technology and automation. Artificial intelligence is expected to assume a much more substantial role than it does today, potentially revolutionizing aspects like back-end operations, scheduling, and patient access. However, it remains to be seen whether the advanced capabilities of large language models and AI, which have shown considerable potential in alleviating cognitive overload, will actually lead to a reduction in healthcare costs.
Vi-Anne Antrum. Senior Vice President and Chief Nursing Officer of Cone Health (Greensboro, N.C.): Health systems will be more focused on value-based care three years from now. This will include transitioning more and more of the care delivery system into the ambulatory, community-based, mobile, and virtual options. Health systems will partner with current payers and/or move into the payer space to reap the benefits derived from creating a higher level of VBC.
Technology and AI will become more prominent for health systems, especially in the labor and provider efficiency space.
Finally, I believe new partnerships will emerge as more and more players enter niche aspects of the market. These niche players cannot provide comprehensive care and will need partners at health systems to effectively manage their desired portion of care. Additionally, health systems can leverage the trust they have built in the communities they serve to convene community partners and policymakers to drive meaningful change in things like behavioral health and workplace violence.
Charles "Ken" Dunham, MD. Executive Director Medical Operations, Behavioral Health of Sentara Healthcare (Norfolk, Va.): In three years, health systems (especially those with affiliated primary care networks) will be tackling a new wave of patients that have screened positive with depression needing both a follow-up plan and treatment to remission. This will be a consequence from Medicare's continued pursuit of preventive measures that include finding and tackling depression before it has worsening consequences on a person's physical and mental well-being.
Healthcare systems should put strategies in place now to meet these needs. We know that finding and treating depression improves health outcomes as well as medical expense ratios. Healthcare systems that figure out how to screen and treat patients with depression will be poised to benefit from value-based contracts with health plans.
Karyn Baum. Chief Transformation Officer of Essentia Health (Duluth, Minn.): Three years from now I expect many, if not most, systems will be actively experimenting with where they can utilize AI to augment their care delivery and operations. I do not believe that AI will be at the point of replacing the amazing people we have within healthcare, but it may improve efficiencies and supplement our work. For example it may help us draft memos, scan for best practices, brainstorm for ideas, or draft a clinic note for a busy clinician.
Systems will also continue to partner with new entrants into the healthcare space, such as Amazon and Costco. These partnerships will create renewed need for the ability to share data and information safely and securely, so patients experience seamless and safe care delivery. I hope that continued focus on value-based care and population health will lead to these partnerships, and appropriate AI use, beginning to improve life expectancy again and allow us to make up some of the ground we lost over the past few years.
Jill Wiedemann-West. CEO of People Incorporated Mental Health Services (Eagan, Minn.): Healthcare systems will be forced to redefine how care is delivered. Systems will be required to focus on data-driven solutions in care, outcomes, and population health. Additionally, systems will find it necessary to redefine healthcare partnerships and provider alignments that drive sustainability.
Maryann Alexander, PhD, RN. Chief Officer of Nursing Regulation at National Council of State Boards of Nursing (Chicago): The last few years proved that change is imperative to sustain the nursing and broader healthcare industry. With the NCSBN 2022 Workforce Study revealing that almost one-fifth of 4.5 million total registered nurses intend to leave the workforce by 2027, health systems must enact solutions to address nursing staffing, wellness and workplace violence.
A recent NCSBN solutions-oriented symposium with leading healthcare professionals crystalised the below solutions:
- Increase virtual nursing workforces to help frontline nurses devote more time to patient care, freeing time for admission and discharge processes to be facilitated by virtual nursing workforces. — Lavonia Thomas, DNP, RN, NEA-BC, Nursing Informatics Officer at MD Anderson
- Create a wellness standard between nurses and their shift leaders. — Debbie Dawson Hatmaker, PhD, RN, FAAN, Chief Nursing Officer at the American Nurses Association
- Support federal and state legislation that funds grant programs, such as the Workplace Violence Grant Program, to provide security funding for healthcare facilities in need that protects patients and healthcare workers. — Kristin Benton, DNP, RN, Executive Director of the Texas Board of Nursing
Health system leaders must identify how to implement these solutions among others to support their nursing workforce and protect the public.
Patty Donley, Vice President of WellSpan Health (York, Pa.); President of WellSpan Good Samaritan Hospital (York, Pa): In the next three years, amidst the aging baby boomer generation and a predicted shrinking supply of healthcare professionals, effective health systems will embrace transformational change in the workforce of the future and the landscape of care delivery. By advancing the use of technology, leveraging alternate care delivery models (including genomic care pathways), and initiating innovative partnerships, health systems can improve access challenges and workforce shortages to more effectively meet the evolving needs of the communities we serve.
Bill Munley. Market Administrator, Southeast of Shriners Hospitals for Children - Greenville (S.C.): Three years from now, I feel more health systems will eliminate unprofitable services and other hospitals will close, similar to what we are seeing now. I also believe that value-based care will dominate payer contracts, and that the number of Medicaid enrollees will grow, as will underinsured/uninsured patients. To deal with this, health systems should form mutually beneficial alliances, now more than ever.
Michael Prokopis, MBA, MS. Vice President, Supply Chain of MD Anderson Cancer Center (Houston): As MD Anderson expands its footprint in Texas, we will see increased complexity in the supply chain and elongation of the distribution/logistics model. This activity will heighten the need for end-to-end inventory management solutions with embedded machine learning to ensure the right product reaches the right location at the right time.
Chad M. Teven, MD. Reconstructive Microsurgeon, Assistant Professor, Clinical Surgery at Northwestern University Feinberg School of Medicine (Chicago): Over the next few years, health systems will likely realize a broader integration of telemedicine and digital health tools, facilitating more comprehensive and accessible remote care options for patients in the U.S. and around the world. Also, artificial intelligence (e.g., machine learning) will play an increasingly important role in healthcare, including but not limited to assisting in diagnostics, treatment planning, and offering a more personalized approach to medical care.
Furthermore, there will likely be a heightened focus on preventative care and population health management, leveraging data analytics to anticipate and address health issues before they escalate. Finally, one thing is for certain: change is coming. It will likely occur in both expected, as well as unexpected, ways.
Thomas Maddox, MD. Vice President, Digital Products and Innovation of BJC HealthCare/Washington University School of Medicine (St. Louis): The move to a more digitally-enabled healthcare system will be well underway. Virtual care will just be another way to receive care, remote monitoring of chronic conditions will be standard, and both predictive and generative AI will be contributing real value to both clinical care and health system operations.
Baruch S. Fertel, MD. Vice President, Quality and Patient Safety, at NewYork-Presbyterian; Associate Professor of Emergency Medicine at Columbia University Vagelos College of Physicians and Surgeons (New York City): With wages and overhead costs increasing, healthcare systems will use technology and automation for tasks that were previously done manually. Radiology (imaging), pathology, and lab are some specialties ripe for disruption where physicians can be used for oversight/confirmation as opposed to initial interpretation. AI/machine learning will also be used to comb charts for red flags/quality opportunities and to pinpoint units or other areas where QA efforts should be directed. Teams will need to work smarter and more efficiently to stay lean and competitive.
Kimberly Cantees, MD. Vice Chair, Equity, Diversity and Inclusion at University of Pittsburgh Anesthesiology and Perioperative Medicine Department; Clinical Director, Anesthesiology and Perioperative Medicine at UPMC Presbyterian Hospital: Healthcare systems will change dramatically over the next 10 years, mainly due to non-sustainable financial constraints. I believe that changes in the next three years will include significant changes in the surgical services :
- Movement of cases ( and case types ) to ambulatory surgery centers: While most large medical centers have some ambulatory surgical capacity, this is not maximized; especially in large academic centers. Traditional " inpatient" surgical care will be shifted to ambulatory centers if regulatory and state health department regulations can be overcome.
- Increasing move towards "acute hospital care at home": This concept widely adopted internationally has been shown to provide safe and satisfactory care. Surgical case volume that is moved to ambulatory facilities automatically necessitates "home" postoperative care and would then be first steps in a hospital-at-home program. Inpatient medical care moved to home care decreases the length of stay with those realized economic benefits
- Integrated delivery networks will continue to expand: Integrated healthcare is the most cost-efficient in terms of resource use and ability to control costs throughout. When the integrated network includes an insurance product, significant economic advantage can be gained. Theoretically, In an integrated healthcare delivery system, all care providers, employees, and patients are aligned in their mission to reduce healthcare costs.
Matthew Webber. Director, Pharmacy Business of Novant Health (Winston-Salem, N.C.): In the coming years, healthcare systems will increasingly prioritize outpatient care, emphasizing enhanced patient experience and convenience. This shift will focus more on preventive healthcare, influencing outpatient services with a greater focus on wellness programs, mental health support, and overall population health initiatives. Anticipate a sustained expansion in specialty pharmacy services, spanning traditional specialty pharmacy and specialty infusion segments. Collaborative initiatives between outpatient providers and technology companies will spearhead innovations in medication management, telehealth solutions, and patient-centric care, all aimed at meeting the evolving preferences of healthcare consumers seeking tailored and comprehensive services.
Edith Okolo, PharmD. Director of Pharmacy of Cedar Crest Hospital (Belton, Texas): Telemedicine will definitely be on the rise and will end up being the new normal. As most patients and providers will prefer meeting virtually whenever circumstances are appropriate for a virtual visit. All healthcare jobs that can be done virtually will be moved remotely especially patient monitoring and any wearable gadgets that record readings that can be digitally transmitted.
Technology will increase digital medicine and access to healthcare due to online accessibility with a click. Patients will be able to schedule appointments online and also have a doctor's visit all at their convenience.
Healthcare practitioners will also be affected in the coming years as we see a shift from medical doctors to providers who are advanced practice clinicians being the custodians of primary healthcare.
Most pharmacy operations will be taken over by robotics. Pharmacy dispensing kiosks will be utilized more. Mail order pharmacy will rise as more people will have their medications mailed to their home. Pharmacy remote order entry services will expand to accommodate working from home.
Robotic surgery is already on the surge, with all types of robots invented for performing various surgeries.
Data will be easily accessible which will lead to more information, research, discoveries and development.
Healthcare costs will soar for patients due to the convenience of accessing healthcare from the comfort of their homes. Of course, the cost of acquisition of the technology to set up remotely, having each individual health personnel visit homes to perform one procedure or the other also add to the cost.
Another area that may be in the pipeline is mobile healthcare, mobile urgent care vehicles, fully equipped mobile hospitals and emergency mobile vehicles that primarily visits homes and are equipped to connect virtually.
I love this question! And I think the primary reason I love it so much is that, to a higher degree than any time in modern history, we really don't know. The COVID-19 pandemic moved the evolution of telemedicine ahead exponentially, making millions of dollars available to more sectors of our healthcare system than ever before. This jump alone changes the chess board dramatically. But when coupled with the advances being made in the field of AI, the potential we have for rapid, exceptionally innovative change is unlike anything we have seen before.
Annie Thomas-Landrum, MSN, RN. Board of Directors of Sunshine Community Health Center (Talkeetna, Alaska): That is why I find it completely fascinating that so many grassroots changes we are seeing in response to this revolution of technology center around going back to our roots and connecting with old playbooks. Primary care clinics continue to explore moving away from insurance with cash-only business models that remind me of the relationship Dr. Baker had with his patients in Walnut Grove (shameless Little House on the Prairie reference from this Kansas girl!). And hospitals are opening up their own LPN programs to train nurses the way both my Grandmothers earned their tiny, starched white nursing caps. The key denominator to me in both of these examples is connection.
As technology allows telehealth and AI to expand healthcare access to more people than ever before, decreasing the number of people it takes to deliver service, we are seeing a corresponding shift towards enhancing the quality of real human interactions. When doctors aren't subject to documentation guidelines driven by federal insurance programs, they tend to have more time to spend focused on the patient. Federal programs themselves have recognized the care provision cost of overly arduous charting standards and as a result, CMS is working to create standards that emphasize care of the patient over care of the medical record. And when hospitals grow their own through their training and certification programs in-house, the benefits of a mentorship model of training can be profound when done well.
So what does this mean for the next three years in healthcare? I believe the changes we will see will be driven by the paradox of human helpers helping human patients through the power of connection that is fueled by technology. And I think the process of finding a balance in between these poles of change will be every bit as messy as that thought sounds. And yet, what an incredible honor is ours…to be able to lead the journey through that doorway. May the choices we make as we do find us worthy of the trust bestowed on us.
Paul Coyne. Senior Vice President and Chief Nurse Executive of HSS | Hospital for Special Surgery (New York City): Healthcare is at a pivotal juncture. It needs to be fixed. And we are approaching the convergence of our desire and technology development where we may be able to potentially fix it. Amidst this excitement, we must remember that the best changes typically do not come when we seek to escape that which is not desirable, but when we seek to enhance that which is desirable. The more rapid the change, the greater the risk of losing that which is worth keeping. In three years, if we do it right, health systems will look different because we will have better used technology to restore our true purpose, with a primary focus on caring, about the individuals in our organizations – and most importantly, our patients.
If we do not do it right, health systems will look different, but we will have drifted further from this focus due to the artificial medium. Technology is the constant. The variable is what we will use it for.
Sriram Vissa, MD. Chief Medical Officer and Vice President of Medical Affairs at SSM Health DePaul Hospital (Bridgeton, Mo.): Health systems will be more consumer-centric and personalized care, where consumers have more access, choice, and control over their own health and well-being. Health systems will adopt more digital and virtual modes of care delivery, such as telehealth, remote monitoring, and home-based care, to ensure the continuity and accessibility of essential health services.
There will be more collaboration and integration, allowing for data exchange and coordination among different stakeholders, such as health plans, providers, pharmaceutical companies, medical device manufacturers, and consumers. Cyber threats and security, HIPAA, and data privacy will be high priorities. Value-based care and population health will make health systems focus more on preventing and delaying the onset of diseases rather than treating them after they occur. This will improve the quality of life and reduce the burden of chronic diseases and costly hospitalizations.
Brad Martin. Associate Director of Care Innovation & Community Improvement Program at UC Health (Cincinnati): The biggest difference will be a shift in the definition of 'health system' from a self-contained organization to an ecosystem of many organizations. Many service lines that are part of larger health systems today, such as primary care, behavioral health, and ambulatory surgery/services, are going to be increasingly cut away by outside consumer health competitors.
While larger health systems and academic medical centers may still offer these services, non-traditional actors such as CVS, Walmart, and Kroger or other organizations like ASCs will represent increasingly large shares of the market in most areas across the country. This is particularly relevant in primary care as it is a primary referral source to the other major revenue-generating service lines. With other competitors in the market directing patient referrals, health systems will be forced to either redefine their operational models to hyper-focus on patient experience and outcomes to maintain market share or to establish formal partnerships with these other organizations to maintain referral pathways and levels.
While this seems like a mildly depressing business-minded change, it will also coincide with a shift in mindset to focus on an 'ecosystem of care' that includes both health actors and community agencies addressing all health needs of the patient.
Jill Hoggard Green, PhD, RN. President and CEO of The Queen's Health System (Honolulu): More and more, health systems will aim to reduce care provided in an acute care setting and increase care provided at integrated care complexes that house under one roof urgent care, diagnostic and advanced imaging, ambulatory surgery, and primary and specialty care practices, such as oncology, urology, cardiology and orthopedics. These careplexes will not only minimize care fragmentation, addressing healthcare needs before they reach a critical state that can only be cared for in an acute care setting, they also will increase access to care that is close to home for everyone.
It also should go without saying that AI technologies will continue to revolutionize healthcare. At The Queen's Health System, we are elevating data as a strategic asset so we can better understand the populations we serve and design the models of care that are best for them. This will be especially important for reducing health disparities, improving health outcomes for those who are most vulnerable, and reducing the overall cost of care so it remains affordable for everyone.
Stephanie Everett. Administrator and CEO of Mountrail County Health Center (Stanley, N.D.): The way providers do care will be different. With value-based care coming into play, the way a health system will approach the entire patient care path will be streamlined. Patients underlying issues will be focused on by CCM programs, in hopes that maintenance screenings and care can curb long-term illnesses.
Scott Jessie, MSN, MBA, RN. Chief Nursing Officer of SUNY Upstate University Hospital (Syracuse, N.Y.): Health systems will continue to adapt and change rapidly over the next three years. Machine learning, generative AI, and advanced data analytics will usher in new ways to deliver care, manage operations, and improve access. Workforce challenges will continue to strain finances and competition will look different as traditional market competitors find ways to collaborate and strengthen care delivery in their service areas.
It will be an exciting and challenging time. We will need exceptional leaders and innovation to ensure we can continue to meet the needs of our patients and communities and deliver on our organization’s missions.
Pradeep Kadambi, MD. President and CEO of the University of Florida Jacksonville Physicians; Senior Associate Dean for Clinical Affairs of UF College of Medicine – Jacksonville: Here are some things that will change, in my opinion:
1. Broader integration of AI/deep machine learning in our daily operations.
2. Patients will play a greater role and will be highly engaged in their care.
3. Shift in care delivery models away from healthcare facilities to accommodate community and home-based care
4. My boldest prediction—A company (either a newly formed healthcare company or a non-healthcare company) will change the current paradigm of healthcare delivery/operations.
Dennis G. Sunderman. System Director, HR M&A, NSP/Unconnected, and Provider Services at CommonSpirit Health (Chicago): I believe that over the next three years, the landscape of acquisitions, divestitures, and joint ventures will continue to reshape the healthcare industry. Current and proposed legislation, the continued evolution of ownership groups (nonprofit, for-profit, private equity), and the drive to hire and retain an exceptionally talented team will lead to new innovations and an enhanced focus on the associates affected by a transaction.
The people aspect will continue to gain attention and importance in due diligence activities that assess culture, legal, financial, and regulatory risk, while the onboarding of the acquired workforce will be centered less on the systematic aspects of hiring/departure and more on the experience of the associate regardless of whether they are joining or leaving the organization.
Lynne Fiscus, MD, MPH. President and CEO of UNC Physicians Network (Durham, N.C.): Three years from now health systems will be more customized for consumer segments. As our patients sort themselves into those who are early and frequent adopters of technology, the more traditional patients, and those skeptical of our services, “one size fits all” delivery will no longer serve our patient needs. Meeting patients where they are with when and how they want to interact with us as a health system will be imperative for health systems to continue to be relevant amidst the consumer-focused new market entrants.